Temozolomide (TZM) is a novel methylating agent currently under investigation for treatment of recurrent high-grade
gliomas. Although TZM generates a wide spectrum of methyl adducts, its cytotoxicity has been attributed to mismatch repair (MR)-mediated processing of O(6)-methylguanine:T mispairs.
N3-methyladenine and
N7-methylguanine adducts are promptly repaired by the base excision repair system, unless a
poly(ADP-ribose) polymerase (
PARP) inhibitor is combined to TZM. In this case, the repair process of N-methylpurines cannot be completed and the deriving
DNA strand breaks contribute to cytotoxicity. In this study, we investigated the influence on cell growth and cell cycle of treatment with TZM +
PARP inhibitor in
glioma cells characterized by different susceptibility to TZM. The results indicated that
PARP inhibitor increases growth inhibition induced by TZM in either p53-wild-type or p53-mutant
glioblastoma cells, as early as 24 h after
drug exposure. The enhancing effect exerted by
PARP inhibitor was particularly evident in
glioma cells characterized by a defective expression of MR, since these cells are tolerant to
O(6)-methylguanine damage and show low sensitivity to TZM. In
O(6)-alkylguanine-DNA alkyltransferase (OGAT)-deficient and MR-proficient
tumor cells bearing wild-type p53, the
drug combination markedly reduced cell accumulation in the G(2)/M phase of cell cycle and induction of the G(2) checkpoint regulator
Chk1 kinase. In short-term cultures of
glioma cells derived from surgical specimens,
PARP inhibitor enhanced chemosensitivity to TZM and this effect was especially evident in OGAT-proficient
tumors. Thus, a pharmacological strategy based on the interruption of N-methylpurine repair might represent a novel strategy to restore or increase
glioma sensitivity to TZM.